Using 0.25mg Finasteride to Lessen Side Effects

/by William Rassman, M.D./1 /,

Hello Dr, I have used propecia in the past with a loss of libido and erection problems.So for the past year i have been using Revivogen. Revivogen has stopped further hairloss for me but has not given me any regrowth. So four months ago i decided to use rogaine, But rogaine gave me bad water retention and facial swelling so i stopped using it one week ago. I am planning to go and see my doctor tomorrow to get a prescription for propecia again. I plan to use 0.25 daily. I have heard that using this low dose has a low side effect rate. Do you think that adding propecia to my regimen of revivogen will give me some good regrowth? I have a feeling that these two products will work very well together.Thanks

Your guess is as good as mine with regard to Revivogen and Propecia (finasteride 1mg) when used together. I’ve written about Revivogen in the past (see Revivogen vs Propecia).

There are reports that 0.25mg of finasteride has only about 25% the effects of 1mg, but it still has some benefit… and your chances of side effects are likely less.

Tags: revivogen, finasteride, hairloss, hair loss, rogaine, minoxidil

Discolored Recipient Area Months After Hair Transplant

/by William Rassman, M.D./0 /

It has been 3 months since my hair restoration surgery of 1600 grafts in my hairline. I am experiencing a prolonged purplish discoloration in certain areas of my recipient site. I can even visualize the line that was drawn for my new hairline although none of the new hairs have grown in. I am a Fitzpatrick type 4 skin type. It seems like the discoloration IS fading but slowly. Is this normal? Will it continue to fade? What can I do to speed up the process? I greatly appreciate your input and expertise. Thank you

Discoloration rarely lasts months as you report, but as you report it is fading and I would expect it to do so. Ask your hair transplant doctor about it. Good luck.

Tags: hairtransplant, hair transplant, discoloration, purple, hairloss, hair loss

Plucking Out My Old Hair Plugs

/by William Rassman, M.D./0 /,

I had one procedure done around 10 years ago. I was young, and like many, I jumped without doing too much research. I’m glad that I stopped at the one procedure. Now I’m looking for a way to reverse the whole thing. The scar is hard enough to keep hidden, but the hair plugs are even harder to deal with. Is there any way to get rid of the transplanted hair besides shaving it or tweazing it? Tweazing the 600 grafts takes too long, and like a beard, they grow back a few hours later after shaving them. I thought about lazer hair removal, but I’m worried that it will permanantely damage the dormant follicles, and with just my luck, they’ll find a cure a week later!

I really do not know your specific problem and the extent of the “pluggy” appearance to give you a personalized opinion. However, it may be almost impossible to completely undo old (or new) hair transplants, because a hair transplant is permanent. It goes to stress the importance of good research and being able to see the results of patients from the doctor as well as the medical group you are having the surgery with. Even 10 years ago, the pluggy transplants were not standard care.

You can try laser hair removal, but you may be left with scarring if the old grafts were the large plugs. Large plugs often leave a cobblestoned skin and depigmentation where the plugs were. Sometimes, these can be cored out, but an experienced hair surgeon needs to evaluate you for this option. Otherwise you can attempt another hair transplant to disguise the old plugs.

For more information on repairing old hair plugs, please see:

Tags: hairtransplant, hair transplant, fue, plugs, hair plugs, repair

Math Problem — Making a Class 7 Look Like He Has No Hair Loss

/by William Rassman, M.D./2 /

This is a follow-up to last week’s How Many Grafts to Give Dick Vitale Hair Like Brad Pitt?

Doctor by saying you would need 40000 hairs to give mr Vitale the coverage mr Pitt has, do you mean that 40000 hair could produce the coverage but not the density? Cause otherwise the numbers don’t add up. A head like mr Pitt’s has at least 100.000 hairs right? Now, assuming that Vitale has kept about 10.000 hair at the back of his head : 40.000 + 10000 = 50000

What am i calculating wrong?

Brad PittWe at NHI have produced wonderful, full-looking heads of hair with a total of 50% of the original density. If Brad Pitt would allow me to pull out every other hair behind his hairline, I don’t believe that you would be able to tell that he lost 50% of his density. One doctor actually did this on a human volunteer and found (using good photography) that in this white male with black hair, observers and photographs could not tell the difference. The contrast of the black hair against white skin is what makes this most interesting.

This is an important observation, because if 50% is the amount of the original density a white male with black hair needs to appear full, then a white male with light brown hair may only need 20-30% of his original density, and a white male with blond hair may only need 10-20% of his original density to look full. The color contrast also extends to dark skinned people who have matching hair colors and they may behave just like the blond hair white skinned man I discussed above.

Tags: math, hairloss, hair loss, hairtransplant, hair transplant, vitale, pitt

Minoxidil and the Sun

/by William Rassman, M.D./0 /

Hello Doctor,

I am a 24 year old Caucasian male. Since my early twenties I started noticing a little hair loss. Now it has gotten to the point that I find hairs everywhere. I work on a computer all day and I constantly find new hairs with what seem to be roots attached to them on my keyboard, up to 50 a day. And that is just on my keyboard… I can’t imagine what happens when I shower or go running outside.

Also my scalp is terribly itchy all the time. I have spoken to my doctor about my premature hair loss and the itchiness and he told me the only thing that works is Minoxidil 5%. I have been using that for about 3 months now and I do not notice any improvement. Also I live in a very sunny part of the world and I read somewhere that coming in contact with sun a lot when you have Minoxidil applied isn’t very good. Is this true?

The thing that gets me most is that my father now 65 has a head full of hair, and also my mother’s father still had a head full of hair when he was 80. Only one person in the entire family has hair loss problems and that is one of my father’s brothers. And that only started when he was 45. I must say I am quite a hairy person (back, chest, legs ect) and I live a stress free life as far as I can tell.

What could be causing my hairs to fall out so early in my life? Is it all in my genes or is there something else at play? Also what would you suggest? Keep using Minoxidil or maybe start using something like Propecia?

SunMinoxidil can cause irritation to the scalp making it itchy, but there should be no impact of sun exposure for a person who uses minoxidil as directed. The hair loss gene (or genes) can come from either the paternal or maternal side of the family and can even skip generations, so although it might not be immediately apparent, your genetics may still be in play with regard to the hair loss you see.

I can’t suggest prescription medications like Propecia without knowing whether you have genetic hair loss. Minoxidil is an over-the-counter medication, so if you use as directed you should be fine. Many men have experienced substantial benefits from Propecia, but you should first get your hair mapped out for miniaturization to find out if you have male patterned baldness (MPB).

Tags: finasteride, propecia, hairloss, hair loss, minoxidil, genetic, gene

Numbness Months After Hair Transplant

/by William Rassman, M.D./0 /,

I am still feeling numbness over the area of my surgery 2 months after the procedure. Is that normal?

I assume you mean numbness in the donor area (back of the head). Your doctor should check for numbness over the distribution of the major occipital nerves if the numbness is very wide. Most people who feel some numbness are experiencing the cut cutaneous nerves just above the incision. These should not extend more than an inch and they should return in time. Best to check with the doctor who performed your surgery.

Tags: numb, nerves, numbness, surgery, hairtransplant, hair transplant

Cut Myself Shaving — How Long Until I Know Whether the Hair Will Grow Back?

/by William Rassman, M.D./0 /

Hey I was just wondering. I seemed to have cut my chin while shaving about a month or two ago and I was wondering how long it could take for hair to grow back, or when I know it won’t for sure. There are two small hairs that have actually sprouted from the spot of the wound itself, but the area surrounding it (that seems basically unaffected) is not yeilding anything. The spot is smaller than a dime and the cut itself appears to only take up 30% to 40% of the bald spot.

Any information would help. Thanks.

Shaving creamIf you cut deep enough to remove a full thickness piece of your skin (with hair in it), then it might not grow back. Alternatively, if you left the wound open and it healed from the bottom up, it might not have hair in the scar. Otherwise, it should grow back in a few more months.

Tags: hairloss, hair loss, shaving, chin, facial hair, scar, beard, wound

Does Propecia Reduce Body Odor?

/by William Rassman, M.D./0 /

Dear Dr. Rassman,
I am a 32 year old male currently on Propecia for the past 6-7months. I know this might sound a little strange but my wife and I have noticed that ever since the first month of taking Propecia I have had significantly less body odor (particularly in the armpits). I still sweat a lot in sports (and sex) but I rarely require the use of a deodorant like I used to. Have you heard of such a side effect in your experience? I am pretty sure I am not imagining this and it was also confirmed by my wife (who is blessed by a rather well developed olfactory system!). I have not changed my diet or anything else in my life over the past few months that might trigger this. Not that I am complaining about it but apart from this rather beneficial side effect I seem to be perfectly normal!

Thanks for your help.

Interesting. I have not heard about a decrease in body odor from Propecia (finasteride 1mg), but if that is what happened, it sure does sound like a benefit.

Tags: propecia, finasteride, hairloss, hair loss, odor, body odor, smell

Inhibit Body Hair to Combat MPB?

/by William Rassman, M.D./0 /

My question is whether tests been made to show that inhibiting body/facial hair (ie. depilatory cream; lasers or intense light therapy) combats mpb? {all rights are reserved should any tests be carried out because of this post to demonstrate a solution to mpb}

There is no connection between treating your body hair with depilatory creams, lasers, or other such modalities and solving problems related to male pattern baldness (MPB).

Tags: mpb, hairloss, hair loss, depilatory cream, laser, body hair

Diffuse Hair Loss

/by William Rassman, M.D./0 /,

(female) Dear Drs,

I was told that I most likely am suffering from Diffuse Areata, the thing that directed my doctor to this diagnosis is diffuse all over hair loss, brow and lash shed and short tapered hairs shedding out. I can find nothing on the subject, nothing on the net and my doctor admitted he did not understand the disorder.

Could you provide me with information regarding the diffuse form leaving no bald spots but diffuse loss all over the head. What is the general prognosis etc?

Thanks for your help

First, I want to tell you that clinical medical science is a descriptive science in many situation. This is important because what we see is what we are reporting when we diagnose diffuse alopecia areata. What doctors are saying is that there is a diffuse form of the disease that mimics classic alopecia areata, except that it is found all over the head. Some doctors question if this is the same disease, but because it looks like the same entity when the skin is biopsied as localized alopecia areata, the conclusion is that the diffuse variant is different in ways that are not understood. Most people believe that it is an autoimmune disease and we see evidence in what we call chronic and diffuse alopecia areata of the microscopic changes seen in autoimmune diseases.

Second, I can point you to some sites of interest so that you can learn more (but hopefully not confuse you):

Tags: alopecia areata, alopecia, diffuse, hairloss, hair loss

Do Men with Immune Deficiencies (Like HIV) Have Less Chance of MPB?

/by William Rassman, M.D./0 /,

Hi!

Do those with severe immune deficiency, like people with HIV, have a smaller chance of developing an advanced MPB? This is a question that struck me, since the immune system is what eventually attacks/kills the hair follicles if sensitive to DHT?

To understand the immune system and how it affects one’s HIV status and balding, it would take a few pages to elaborate. So to put it simply, the answer to your question is no.

The immune system does not attack and “kill” the hair follicles sensitive to DHT. Your statement is not correct. Hair loss from immune system issues reflect many forms of the autoimmune disease groupings, such as alopecia areata, but the immune system issues regarding HIV and alopecia areata are not related since the target of the antibodies are different, as well as the cause of the disease.

If you have HIV and have the genes for hair loss, you will have HIV and have hair loss (which will almost certainly accelerate if your HIV gets out of control or your diet is not healthy).

Tags: immune system, hiv, immune, mpb, hairloss, hair loss, dht, virus

Diagnosing MPB By Feeling Hair Shaft Thickness?

/by William Rassman, M.D./0 /

Hi Dr. Rassman (or other contributing doctors),
I was wondering if for genetic hair loss (male pattern baldness), you can actually diagnosis yourself by feeling the thickness of the hair shafts on your scalp? So, if hairs that fall out daily look much thinner than your typical terminal hair, and the hair on your scalp also feels thinner, can you be confident of a diagnosis for genetic hairloss, or is a miniaturization test necessary? Thanks alot.

Feeling the thickness of the hair shaft is an art that I’ve learned over time. I can estimate the thickness of a hair shaft when it is rolled between my fingers. I have checked myself with a micrometer to measure my accuracy, and I can tell the difference between fine, medium, and coarse hair. I believe that the miniaturized hairs, when compared to the hair from the back of one’s head, can be felt to have less bulk. That being said, the ‘feel’ will not be as accurate as studying it under video magnification (miniaturization mapping of the scalp), which I promote often on this blog. If you wish, you can buy a micrometer at a hobby shop or over the internet for about $25 and make your own measurements of single hair shafts, but to have real value these shafts must be measured amongst many others.

Tags: diagnose, hairloss, hair loss, miniaturization, thickness

Genetic Defect in Follicle Development?

/by William Rassman, M.D./0 /

I read the response regarding why hair transplants are permanent. I am balding and a biology teacher. (I use hair transplants as an example of grafting.) The question always arises, “Why is the hair different on the sides and back of the head than the top?” In light of your previous entry. What would cause a genetic defect in hair follicle development to affect only specific regions of the head? I would also like to know (because I constantly field questions about the uses of stem cells from my students) would the undifferentiated cells be able to be stimulated into new scalp skin (hair and all) for transplant? I have been presented with information about scientists experiment with growing a heart. Why not complete skin with sebaceous glands, sweat glands, arrector pili muscle, etc.? Thus would be a boon for burn patients as well as those of us who would like some hair back.

Thank you in advance

No one knows why we have developed male pattern baldness (MPB). You are right to ask if we can grow a heart from a stem cell, why not a hair? We actually have grown hairs from stem cells, but the ability to do this was completely inconsistent. Research will hopefully shed new light on this in the years to come.

You can review my previous post on a theory for this at Why Does the Back and Sides of the Head Not Lose Hair?

Tags: hairloss, hair loss, genetic, gene, genes, follicle, stem cell

Would Propecia Make Me Fail a Drug Test?

/by William Rassman, M.D./1 /

Would I fail a drug test if i’m taking nothing but Finasteride 1mg? Would it show as a negative drug for the workplace, school, or even military?

Thank you

Unless they are specifically testing for DHT blocking enzymes, I doubt you would fail a routine drug test. A routine drug test screens for illegal substances. Propecia (finasteride) is not illegal in the workplace, school, or even the military, though it is on the banned list for professional athletes and for people who want to donate blood.

Tags: finasteride, hairloss, hair loss, drug, banned, ban, athlete, blood

Body Hair Loss from Stress After Pregnancy Years Earlier?

/by William Rassman, M.D./0 /

Hello Doctors…
My sister has been losing her hair for 2 years now, she is 22…it all started after she had her first baby…shes been stressed out since then…around 300 hairs fall out a day maybe more…she recently went to a dermatologist and they checked her iron, zinc, and thyroid…they said everything looked good…she is losing body hair or should i say pubic hair and she mentioned something about her eyelashes as well…she gets these red spots on her scalp sometimes…the dermatologist said that her losing her hair is due to the new born she had 2 years ago…is that possible?…i told her to get a second opinion, i mean they should take samples of her scalp or something right?…or could it just be the stress?…i never heard stress making you loss body hair and stuff but i dont know…she decided to get ScalpMed, but i have a feeling it’s not going to work because its not just the scalp that losing hair it’s also everywhere else…what do you think about all this? Thank you for your time.

It is virtually impossible for me to diagnose her over the internet. I think that if she is not satisfied with the one opinion, get another one. Her hair is too important to let this go and what you are describing does sound serious for her hair and psychological state of mind.

Tags: hairloss, hair loss, body hair, pregnancy, pregnant